1. Technical Field
The present disclosure relates to an orthopedic splinting devices, and, more specifically, to a finger splint for children.
2. Description of Related Art
Injuries to fingers and hands are common in children under the age of 5. Some studies show that in the United States, finger injuries account for approximately two-thirds of hand injuries in children. Many injuries in preschool age children are caused by fingers being jammed or crushed in doors. As children get older, finger injuries may result from recreational activity. It can be difficult to treat finger injuries in children due to the small size of their hands and their high activity level. Some children find immobilization of their fingers frustrating and will not leave a splint on for the entire duration of their treatment due to the lack of comfort and its interference within their daily activities.
Common finger injuries include ligament injuries, tendon injuries, sprains, strains, fractures, dislocations, lacerations, avulsions, amputations, or a combination of any of the above. Each finger or phalanx, except the thumb, contains three bony segments (the distal, middle, and proximal phalanx) and three joints which permit bending (flexion) and straightening (extension) of the fingers. The joint between the distal phalanx and the middle phalanx is called the distal interphalangeal joint, the joint between the middle phalanx and the proximal phalanx is called the proximal interphalangeal joint, and the joint between the proximal phalanx and the metacarpal bone is the metacarpophalangeal joint.
A common ligament injury to the finger(s) occurs at the proximal interphalangeal joint. The proximal interphalangeal joint is held together by ligaments, called collateral ligaments, which traverse the joint and attach to the bony segments on either side of the joint. The collateral ligaments of the proximal interphalangeal joint may be injured by a bending or twisting mechanism. When the finger is struck by an object and forced to one side or the other the collateral ligaments may tear resulting in a sprain of the collateral ligaments. Partial tears or sprains of the collateral ligaments are typically treated using a method known as “buddy-taping”. The injured finger is taped to a normal adjacent digit. The tape is worn continuously for a period, such as three weeks, and then for an additional three weeks during periods of anticipated activity. The current method of buddy-taping, with standard cloth tape available in most emergency departments and drug stores, often does not hold up to persistent activity. The tape may fall apart and children tend to remove the tape because it is inconvenient and uncomfortable. The tape tends to get caught in the creases of the fingers becoming very uncomfortable. Parents may try splinting the finger(s) with a stiff bulky material, such as an emery board, which quickly becomes a nuisance for the child and they remove it.
Volar plate injuries may be caused by hyperextension of the proximal interphalangeal joint, and is usually associated with dorsal dislocation of the middle finger. Typical treatment involves closed reduction of the dislocation which anatomically realigns the avulsed ligaments. A dorsal splint is placed on the finger to prevent hyperextension and lateral stresses. A dorsal splint can be difficult to put on a child due to the small size of their fingers and their tendency to remove the splint because it is uncomfortable.
A mallet injury results from an injury to the extensor tendon which is distal to the proximal interphalangeal joint resulting in the inability to flex the distal interphalangeal joint. Due to the small size of children's hands it can be difficult to place a splint on the distal portion of the injured finger or fingers.
A crush injury to the tip of the finger(s) causes one of the most common fractures in children, often resulting from the finger(s) getting caught in a door. Crush injuries may be treated with a foam aluminum splint. However, these splints can be too bulky for a child's finger, and children may remove the splint prior to the end of treatment. Additionally, single-finger splinting may be difficult to maintain even in an adolescent.
Other splinting systems may be very complex, expensive and may be adapted to highly specific finger injuries. Additionally, these splints are not well adapted to be placed on a child's hand because they are complicated to put on and do not accommodate their small fingers. Devices such as the ulnar gutter splint and the volar splint are often bulky and uncomfortable, and children tend to remove the splint prior to the end of the treatment period.
Therefore, there is still a need for a finger splint for use with children that: easily allows the combined splinting of two or more adjacent fingers at one time with a single device; can accommodate small hands; is comfortable to wear for long periods of time; may accommodate open or closed wounds on the fingers; is easy to take on and off; or, is durable to withstand the high activity level of a child.